NPIMap

Organization Active NPI

Columbia Memorial Hospital

  • Multi-Specialty Clinic/Center
  • Hudson, NY
National Provider Identifier
1083639587
Registry record updated May 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
1001000H Issued in NY
Legal business name
COLUMBIA MEMORIAL HOSPITAL
Practice address
71 Prospect Ave
Hudson, NY 12534-2907
Phone
(518) 828-7601
NPI assigned
Jul 13, 2006
Last updated
May 17, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
COLUMBIA MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 17, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Vincent J Dingman III
Title
Chief Financial Officier
Phone
(518) 828-7601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 1001000H NY Primary

Addresses

Primary practice location

71 Prospect Ave
Hudson, NY 12534-2907

Mailing address

PO Box 2000
Hudson, NY 12534-2000
Phone (518) 828-8363

Other names 1

  • Columbia Memorial Hospital Doctors Group Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ, MD, NC, MO, CT, FL, DC, SC, GA, CA, PA, IL13 enrollments

Enrollment records 13

Enrollment IDStateProvider typePAC IDDetails
O20040409000109 NY Part B Supplier - Clinic/Group Practice 5092709410 Receives reassigned benefits from 252 practitioners
15 other NPIs on this enrollment
Practice locations: Catskill, NY; Valatie, NY; Hudson, NY; Copake, NY; Chatham, NY; Albany, NY; Cairo, NY; Hensonville, NY
O20170808001851 NJ Part B Supplier - Clinic/Group Practice 5092709410 Receives reassigned benefits from 1 practitioner
Practice locations: Jobstown, NJ
O20180123000524 MD Part B Supplier - Clinic/Group Practice 5092709410 Receives reassigned benefits from 2 practitioners
Practice locations: Dayton, MD
O20190821000426 NC Part B Supplier - Clinic/Group Practice 5092709410 Receives reassigned benefits from 2 practitioners
Practice locations: Cary, NC; Durham, NC
O20210401000281 MO Part B Supplier - Clinic/Group Practice 5092709410 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO
O20210821000367 CT Part B Supplier - Clinic/Group Practice 5092709410 Receives reassigned benefits from 1 practitioner
Practice locations: New Haven, CT
O20220210000330 FL Part B Supplier - Clinic/Group Practice 5092709410 Receives reassigned benefits from 1 practitioner
Practice locations: North Port, FL; West Palm Beach, FL
O20220712002058 DC Part B Supplier - Clinic/Group Practice 5092709410 Receives reassigned benefits from 1 practitioner
Practice locations: Falls Church, VA
O20220720000561 SC Part B Supplier - Clinic/Group Practice 5092709410 Receives reassigned benefits from 1 practitioner
Practice locations: Piedmont, SC; Simpsonville, SC
O20230523002096 GA Part B Supplier - Clinic/Group Practice 5092709410 Receives reassigned benefits from 2 practitioners
Practice locations: Atlanta, GA; Columbus, GA
O20240315002560 CA Part B Supplier - Clinic/Group Practice 5092709410 Receives reassigned benefits from 2 practitioners
Practice locations: Anaheim, CA; Sunnyvale, CA
O20240501003554 PA Part B Supplier - Clinic/Group Practice 5092709410 Receives reassigned benefits from 1 practitioner
Practice locations: Philadelphia, PA
O20260430002428 IL Part B Supplier - Clinic/Group Practice 5092709410 Receives reassigned benefits from 1 practitioner
Practice locations: Mundelien, IL

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory
Part of
Dilara Z Khandaker

Locations

2693 W Lincoln Ave
Unit 2
Anaheim, CA 92801

Practitioners & affiliated clinicians

Practitioners 264

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 264

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274054400000",
    "number": "1083639587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2000",
            "city": "HUDSON",
            "state": "NY",
            "postal_code": "125342000",
            "telephone_number": "518-828-8363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 PROSPECT AVE",
            "city": "HUDSON",
            "state": "NY",
            "postal_code": "125342907",
            "telephone_number": "518-828-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLUMBIA MEMORIAL HOSPITAL",
        "enumeration_date": "2006-07-13",
        "last_updated": "2010-05-17",
        "status": "A",
        "authorized_official_last_name": "DINGMAN",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICIER",
        "authorized_official_telephone_number": "518-828-7601",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NY",
            "license": "1001000H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia Memorial Hospital Doctors Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hudson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.